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Childhood brain injuries from sports in Canada avoidable

A major Canadian study looking at how children get hurt while playing sports suggests many brain injuries could be easily avoided with better equipment, rule enforcement and supervision.

Lead author and neurosurgeon Dr. Michael Cusimano said he was surprised by the findings, which show a large number of youngsters get injured by running into goalposts and getting hit in the head by baseball bats, and from rule violations such as kicks to the head and hits from behind.

“It is such an eminently fixable problem,” he said.

Described as the first comprehensive analysis of the mechanisms of pediatric brain injuries from team sports, the study, led by St. Michael’s Hospital, looked at 12,799 cases between 1990 and 2009.

Youngsters studied ranged in age from 5 to 19, who ended up in emergency departments of 11 pediatric and four general hospitals across Canada.

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The study found that hockey accounts for 44 per cent of all brain injuries, soccer 19.02 per cent, football 12.9 per cent, basketball 11.6 per cent, baseball 6.52 per cent and rugby 5.63 per cent.

Of children ages 5 to 9 who sustained brain injuries while playing soccer, 12.5 per cent result from striking an object such as a goalpost or net.

“The really young kids running into goalposts surprised me a lot. I didn’t expect it would be that high,” Cusimano remarked.

Padding the posts, and ensuring they are flexible and not firmly stuck into the ground could help rectify the problem, he said.

Alan Gould, executive director of the Toronto Soccer Association, noted that, as of a year ago, smaller nets that are not firmly stuck into the ground have been used for players up to age 11 (inclusive).

“Portable nets are being introduced across Canada, for the purpose of providing more appropriate goal size, but with the added benefit of providing more give when collisions occur,” he said.

But he went on to explain that soccer clubs typically rent facilities from school boards and municipalities, so it is difficult for them to make changes to the equipment.

The study found that kicks to the head account for a large number of brain injuries sustained by soccer players, specifically 9.7 per cent for players ages 15 to 19.

Rules prohibiting this aren’t always strictly enforced, Cusimano said, adding that tougher penalties would also help abate the problem.

Ten per cent of brain injuries in hockey result from players getting hit from behind, even though this has been a violation of rules for decades.

“That surprised me because I thought we had dealt with that problem. We think we are doing a good job here and we are still seeing (this),” Cusimano said, adding that better enforcement is also a solution here.

Todd Jackson, senior manager of insurance and management services with Hockey Canada, welcomed the findings, saying such precise evidence will help guide the organization in making the game safer.

“We are always looking at the research and information coming out as we look at injury prevention . . . It will be used to discuss next steps with respect to enforcement,” he said.

The study also found that sports assumed to be low injury, such as baseball and basketball, aren’t always so.

For example, 30 per cent of all baseball injuries are sustained by children ages 5 to 9 who are struck by a sport implement, such as a bat.

That can happen when little ones still learning the rules of the game stand too close to the batter, Cusimano, noted, adding that better supervision could help on this score.

Cusimano also recommended making changes to boards of directors of sporting organizations, arguing that many are made up of men, often former players, who sit on them for years. They tend to want to protect the status quo, he said.

The presence of more women and current players on boards could help make the games safer, he said.

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